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STATCARE PLUS, INC.
NPI 1194026260
Family Medicine in Mccomb, MS

Active since November 05, 2010CLIA 25D2021481 · Waiver
1015 DELAWARE AVE, SUITE C, MCCOMB, MS 39648(601) 249-4777(601) 249-4776 Get Directions Write a Review

NPPES record last updated: November 1, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 1, 2021, Jan 11, 2018, Jul 27, 2017 (3 updates tracked since 2017).

About Statcare Plus, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STATCARE PLUS, INC. (NPI 1194026260) is a healthcare organization registered as a family medicine in Mccomb, Mississippi and active in the NPI registry since November 2010. The organization holds a CLIA Waiver certificate valid through March 14, 2027 and lists Debra Kennedy, Administrator, as its authorized official.

NPPES Registry Identity

NPI1194026260
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSTATCARE PLLC
Location Address1015 DELAWARE AVE, SUITE CMccomb, MS 39648-3827
Mailing Address1015 Delaware Ave, Suite CMccomb, MS 39648-3827 · (601) 249-4777 · Fax (601) 249-4776
Phone(601) 249-4777
Fax(601) 249-4776
Organization SubpartNo
Authorized OfficialDebra KennedyAdministrator · (601) 250-1122
Enumeration DateNovember 5, 2010
Last NPPES UpdateNovember 1, 20213 updates tracked since enumeration
NPPES CertifiedNovember 1, 2021
✔ NPI 1194026260 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1015 DELAWARE AVE, Mccomb, MS 39648
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Other Names 1

Doing Business AsStatcare Plus, Inc.

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Statcare Plus, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

10

Medicare enrollment records show 10 clinicians reassign Medicare billing to Statcare Plus, Inc., which bills Medicare for the services they deliver. Of these, 7 practice at this address and 9 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 2

Nurse Practitioner6
Emergency Medicine4

Clinicians, nearest first (10)

John Harvey, FNP-C
Nurse Practitioner
NPI 1982012548
1015 DELAWARE AVE # C
Mccomb, MS 39648
(601) 249-4777
✔ PECOS✔ Accepts MedicareSame address
Christopher Bracey, FNP
Nurse Practitioner
NPI 1578084521
1017 DELAWARE AVE
Mccomb, MS 39648
(601) 250-1122
✔ PECOS✔ Accepts MedicareSame address
Jackie Brister, F.N.P.
Nurse Practitioner
NPI 1568473270
1017 DELAWARE AVE
Mccomb, MS 39648
(601) 250-1122
✔ PECOS✔ Accepts MedicareSame address
Scott Smith, M.D.
Emergency Medicine
NPI 1629057427
1017 DELAWARE AVE
Mccomb, MS 39648
(601) 250-1122
✔ PECOS✔ Accepts MedicareSame address
Darryl Temple, FNP
Nurse Practitioner
NPI 1730168618
1017 DELAWARE AVE
Mccomb, MS 39648
(601) 250-1122
✔ PECOS✔ Accepts MedicareSame address
Brett Tisdale, M.D.
Emergency Medicine
NPI 1699754572
1017 DELAWARE AVE
Mccomb, MS 39648
(601) 250-1122
✔ PECOS✔ Accepts MedicareSame address
John Watson, D.O.
Emergency Medicine
NPI 1851370795
1017 DELAWARE AVE
Mccomb, MS 39648
(601) 250-1122
✔ PECOS✔ Accepts MedicareSame address
Jodi Waller, FNP-C
Nurse Practitioner
NPI 1811303670
300 RAWLS DR STE 1500
Mccomb, MS 39648
(855) 615-7246
✔ PECOS✔ Accepts Medicare0.5 mi
Brett Ferman, MD
Emergency Medicine
NPI 1578639449
215 MARION AVE
Mccomb, MS 39648
(601) 249-2701
✔ PECOS✔ Accepts Medicare0.6 mi
Melanie Robertson, FNP-C
Nurse Practitioner
NPI 1427567791
102 W FREEDOM DR
Liberty, MS 39645
(601) 657-8091
✔ PECOS21 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2021481

Statcare Plus, Inc · Mccomb, MS
Active · expires Mar 14, 2027
CLIA Number25D2021481
Laboratory TypePhysician Office
Certificate Effective DateMarch 15, 2025
Certificate Expiration DateMarch 14, 2027
Laboratory DirectorJ Andrew Watson
Laboratory Phone(601) 249-4777
Laboratory LocationStatcare Plus, Inc1015 Delaware Avenue, Suite C, Mccomb, MS 39648
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Statcare PLLC's NPI number?

The NPI number for Statcare PLLC is 1194026260. It was assigned to this organization in the NPPES registry on November 5, 2010. The provider is doing business as Statcare Plus, Inc..

Where is Statcare PLLC located?

Statcare PLLC is located at 1015 Delaware Ave Suite C, Mccomb, MS 39648. The listed phone number is (601) 249-4777.

What is Statcare PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Statcare PLLC enrolled in Medicare?

Yes. Statcare PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Statcare PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 2 Medicare specialties reassign their Medicare billing to Statcare PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (6) and Emergency Medicine (4). Of these, 7 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Statcare PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2021481) is associated with this NPI, valid through March 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Statcare PLLC accept?

Health plans from Molina Healthcare list Statcare PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Statcare PLLC was last updated on November 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.